Gynecologic oncology最新文献

{"title":"Granulosa cell tumors: Initial surgical approach and recurrence","authors":"Erin Dwyer ,&nbsp;L’Oreal Kennedy ,&nbsp;Danika Bethune ,&nbsp;Ronit Katz ,&nbsp;Barbara Goff","doi":"10.1016/j.ygyno.2025.12.012","DOIUrl":"10.1016/j.ygyno.2025.12.012","url":null,"abstract":"<div><div>Objective: Granulosa cell tumors account for 3–5% of ovarian cancers with a risk of recurrence of 10–25% in those with stage I disease. Our objective was to evaluate clinical factors associated with disease recurrence, with special attention to the role of initial surgical approach (minimally invasive vs. open abdominal) in recurrence risk.</div><div>Methods: All patients treated for GCT at University of Washington between 1980 and 2020 were included in the study. Retrospective review of demographic, medical/family/history, treatment and recurrence was performed. Descriptive statistical analysis of clinical and pathologic features, Kaplan-Meier curves, and Cox proportional hazards regression were performed.</div><div>Results: 174 patients were evaluated and 62 were eliminated due to incomplete data. 112 patients were included in the analysis sample with a median follow up time of 126 months (range 12–482 months) and median age of 46 years (IQR 37–55). Stage at diagnosis was primarily IA or IC. Surgical approach was open in 59% (<em>N</em> = 66), laparoscopic in 34% (<em>N</em> = 38), and robotic in 5% (<em>N</em> = 5) of patients. Tumor rupture was more common among the minimally invasive surgical approaches, compared to an open approach. Stage, need for adjuvant chemotherapy, and tumor rupture were associated with an increased risk of recurrence during the follow up period. Among patients with tumor rupture, 55% of patients had a recurrence event during the follow up period.</div><div>Conclusion: Tumor rupture at the time of surgery is a significant risk factor for recurrence. There is a higher risk of tumor rupture with minimally invasive surgery. Care should be taken to avoid iatrogenic tumor rupture.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 9-14"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear cell carcinoma of cervix and vagina: A review of 63 cases in the post-DES era","authors":"Reem Saab,&nbsp;Alejandra Brazan,&nbsp;Gary B. Chisholm,&nbsp;Naomi R. Gonzales,&nbsp;Michael Frumovitz,&nbsp;Pamela T. Soliman","doi":"10.1016/j.ygyno.2026.01.773","DOIUrl":"10.1016/j.ygyno.2026.01.773","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical characteristics and oncologic outcomes of cervical and vaginal clear cell carcinoma (cCCC, vCCC) in the post-DES era.</div></div><div><h3>Methods</h3><div>This is a retrospective cross-sectional study of patients diagnosed with cCCC and vCCC between 2000 and 2024. Cervical cancer was staged using the International Federation of Gynecology and Obstetrics (FIGO) 2018 system and categorized as early stage (IA1-IB2, IIA1), locally advanced (IB3, IIA2-IVA) and advanced (IVB). Overall survival (OS) and recurrence-free survival (RFS) were estimated with the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>A total of 63 patients were included: 51 cervical and 12 vaginal. Among cCCC, recurrence occurred in 21 patients (41.2%), with a median OS of 12.96 years (95% CI 8.83, 15.5). Early-stage disease was associated with a higher OS (<em>p</em>-value = 0.01) and RFS (p-value = 0.00049) compared to locally advanced and advanced disease. Lymph node metastasis was associated with poor OS (<em>p</em>-value = 0.0001) and RFS (p-value = 0.0113). In the vCCC group, recurrence was identified in 10 patients (83.3%), with a median OS of 3.26 years (95% CI 0.77, 6.75). Compared to cCCC, vCCC had worse prognosis with lower OS (<em>p</em>-value = 0.0009) and RFS (p-value = 0.0029).</div></div><div><h3>Conclusion</h3><div>Patients with cCCC have more favorable outcomes than those with vCCC, with stage and lymph node metastasis serving as predictors of survival outcomes in cCCC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 39-44"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker heterogeneity and efficacy of durvalumab plus carboplatin/paclitaxel followed by durvalumab with or without olaparib in patients with mismatch repair proficient endometrial cancer: exploratory analyses of the DUO-E/GOG-3041/ENGOT-EN10 trial","authors":"Shannon N. Westin ,&nbsp;Kathleen Moore ,&nbsp;Hye Sook Chon ,&nbsp;Jessica Thomes Pepin ,&nbsp;Erin A. Salinas ,&nbsp;David Starks ,&nbsp;Paul A. Disilvestro ,&nbsp;Brian Slomovitz ,&nbsp;Elen Vettus ,&nbsp;Fernando Gálvez-Montosa ,&nbsp;Kofi Agyemang-Prempeh ,&nbsp;Flora Zagouri ,&nbsp;Jae-Weon Kim ,&nbsp;Qinglei Gao ,&nbsp;Fernando Contreras Mejia ,&nbsp;Andreia Cristina De Melo ,&nbsp;Tadaaki Nishikawa ,&nbsp;Matthew Kowgier ,&nbsp;Sonia Iyer ,&nbsp;Ying Wang ,&nbsp;Els Van Nieuwenhuysen","doi":"10.1016/j.ygyno.2026.01.777","DOIUrl":"10.1016/j.ygyno.2026.01.777","url":null,"abstract":"<div><h3>Objective</h3><div>The phase 3 DUO-E trial demonstrated statistically significant progression-free survival (PFS) benefit with carboplatin/paclitaxel plus durvalumab followed by durvalumab with/without olaparib maintenance versus carboplatin/paclitaxel alone in advanced/recurrent endometrial cancer. We report exploratory analyses of key biomarkers and histology in the mismatch repair proficient (pMMR) subpopulation.</div></div><div><h3>Methods</h3><div>Patients were randomised 1:1:1 to carboplatin/paclitaxel (control arm), carboplatin/paclitaxel plus durvalumab followed by durvalumab (durvalumab arm) or carboplatin/paclitaxel plus durvalumab followed by durvalumab plus olaparib (durvalumab + olaparib arm). The presence of and relationship between selected biomarkers and histology, and PFS were investigated in the pMMR subpopulation.</div></div><div><h3>Results</h3><div>Biomarkers of interest (programmed death-ligand 1 [PD-L1] expression and mutations in <em>BRCA</em>1/<em>BRCA</em>2 genes, homologous recombination repair genes, DNA polymerase epsilon and tumour protein 53 [<em>TP53</em>m]) were evaluable in 486/575 patients in the pMMR subpopulation, with 84% (<em>n</em> = 407) positive for ≥ 1 biomarker; PD-L1 positive (67%) and <em>TP53</em>m (59%) were the most prevalent biomarkers. In the biomarker-known subpopulation, 52% and 27% of patients had tumours of endometrioid and serous histology, respectively. In exploratory analyses, PFS hazard ratios were improved versus control for both treatment arms across multiple biomarker and histology known subgroups, and favoured the durvalumab + olaparib arm in the majority of assessed biomarker/histological subgroups.</div></div><div><h3>Conclusions</h3><div>The DUO-E pMMR subpopulation was highly heterogeneous with frequent overlap of biomarkers and histology. Consistent with the primary analysis, durvalumab plus olaparib improved the PFS benefit observed with durvalumab versus control across a range of biomarker and histological subgroups.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 54-64"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime ovulations and endometrial cancer risk: A systematic review and meta-analysis","authors":"Niki Talebian ,&nbsp;Mahdi Falah Tafti ,&nbsp;Sogol Alikarami ,&nbsp;Francesmary Modugno","doi":"10.1016/j.ygyno.2026.02.006","DOIUrl":"10.1016/j.ygyno.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Lifetime ovulatory years (LOY) estimate the period women are exposed to gonadal hormones in their reproductive life. Research on the relationship between endometrial cancer (EC) and lifetime ovulations is limited. This study investigates the association between LOY and EC risk.</div></div><div><h3>Methods</h3><div>Scopus, PubMed/MEDLINE, and Embase were systematically searched through February 8, 2026, to identify studies reporting the association between lifetime ovulations and EC risk. Two independent reviewers screened the records for eligibility, performed quality assessment, and extracted the relevant data, with disagreements resolved by a third senior reviewer. The pooled effect estimate with a 95% confidence interval was calculated using the random-effects and the meta-regression models.</div></div><div><h3>Results</h3><div>Eleven articles were included in the meta-analysis, of which 6 reported odds ratios, 3 reported hazard ratios, 1 reported incidence rate ratios, and 1 reported risk ratios. Two studies reporting LOY as a continuous variable were included only in the qualitative review. Higher LOY was associated with increased risk of EC with a pooled effect estimate of 2.73 (95% CI: 2.00–3.71). Women with the highest LOY had 2.07 times the odds of EC than women with the lowest LOY (95% CI: 1.50–2.85). Moreover, the pooled hazard ratio was 5.27 (95% CI: 3.43–8.10). Leave-one-out analysis did not significantly change the pooled estimates.</div></div><div><h3>Conclusions</h3><div>LOY is a risk factor for EC. Further studies with a standard definition of LOY are necessary to assess its association with EC risk more precisely.</div><div>PROSPERO Registration: 13 September 2025, CRD420251146449.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 106-116"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival outcomes and time toxicity of Sandwich versus Sequential chemoradiation in Stage III endometrial cancer: A real-world study stratified by molecular classification","authors":"Kuang-Yen Lee ,&nbsp;Tzu-Hsin Tseng ,&nbsp;Wen-Chun Chang ,&nbsp;Yi-Jou Tai ,&nbsp;Chin-Jui Wu ,&nbsp;Ying-Cheng Chiang ,&nbsp;Lin-Hung Wei ,&nbsp;Bor-Ching Sheu","doi":"10.1016/j.ygyno.2026.02.007","DOIUrl":"10.1016/j.ygyno.2026.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the survival outcomes of Sandwich (Chemo-RT-Chemo) versus Sequential (Chemo-RT) therapy in Stage III endometrial cancer, focusing on the interplay between treatment intervals, time toxicity, and molecular classification.</div></div><div><h3>Methods</h3><div>We analyzed 119 patients with Stage III EC (2015–2025) receiving either Sequential (<em>n</em> = 42) or Sandwich (<em>n</em> = 77) regimens. Endpoints included overall survival (OS), progression-free survival (PFS), relative dose intensity (RDI), and overall treatment time (OTT). Outcomes were stratified by p53 and MMR status.</div></div><div><h3>Results</h3><div>Among 119 patients (42 Sequential, 77 Sandwich) with well-balanced characteristics, no significant differences were observed in OS (<em>P</em> = .73) or PFS (<em>P</em> = .93). However, subgroup analysis favored the Sandwich regimen in pMMR tumors (PFS benefit, <em>P</em> = .026) and p53-mutant tumors (improved time-to-recurrence, <em>P</em> = .034). Regarding time toxicity, the Sandwich cohort demonstrated significantly shorter median overall treatment time (198.0 vs. 223.0 days; <em>P</em> &lt; .001) and earlier radiotherapy initiation (77.0 vs. 171.5 days; P &lt; .001). Chemotherapy dose intensity remained comparable (<em>P</em> = .878). While low-grade diarrhea was more frequent in the Sandwich arm (43% vs. 21%; <em>P</em> = .027), grade≧3 adverse events were rare and similar between groups.</div></div><div><h3>Conclusions</h3><div>The Sandwich regimen offers a dual advantage: it reduces patient time toxicity and ensures earlier pelvic control without sacrificing chemotherapy intensity. This optimized temporal sequencing appears particularly beneficial for high-risk molecular subtypes (p53-mutant/pMMR) and supports the paradigm of molecular-directed adjuvant therapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 117-124"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ready, Set, GYO: Lessons learned from a fellow-developed podcast in gynecologic oncology","authors":"Maya Gross ,&nbsp;Skye Jacobson ,&nbsp;Bunja Rungruang ,&nbsp;Kilee Knight ,&nbsp;Sydney Oesch","doi":"10.1016/j.ygyno.2026.01.211","DOIUrl":"10.1016/j.ygyno.2026.01.211","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S19"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative DNA damage as a predictive biomarker for recurrence and survival in high-grade serous ovarian cancer","authors":"Carson Edwards ,&nbsp;Dhruva Dave ,&nbsp;Rebecca Arend ,&nbsp;Valeria Dal Zotto ,&nbsp;Natalie Gassman","doi":"10.1016/j.ygyno.2026.01.207","DOIUrl":"10.1016/j.ygyno.2026.01.207","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S17"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase II study of cadonilimab monotherapy for recurrent small cell neuroendocrine carcinoma of the cervix","authors":"Helen Clark,&nbsp;Kelly Rangel,&nbsp;Zhouxuan Li,&nbsp;Ying Yuan,&nbsp;Shannon Westin,&nbsp;Amir Jazaeri,&nbsp;Travis Sims","doi":"10.1016/j.ygyno.2026.01.203","DOIUrl":"10.1016/j.ygyno.2026.01.203","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages S14-S15"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FOREWORD — SGO Winter Meeting","authors":"","doi":"10.1016/j.ygyno.2026.01.184","DOIUrl":"10.1016/j.ygyno.2026.01.184","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S1"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substratification of mismatch repair deficient endometrial cancers based on mechanism of MMR loss can provide prognostic and predictive refinement","authors":"Amy Jamieson ,&nbsp;Sila Rogan ,&nbsp;Allen W. Zhang ,&nbsp;Spencer D. Martin ,&nbsp;Samuel Leung ,&nbsp;Derek Chiu ,&nbsp;Kathryn McRae ,&nbsp;Sarah J. Mah ,&nbsp;Stefan Kommoss ,&nbsp;Aline Talhouk ,&nbsp;David G. Huntsman ,&nbsp;C. Blake Gilks ,&nbsp;Jessica N. McAlpine","doi":"10.1016/j.ygyno.2026.01.233","DOIUrl":"10.1016/j.ygyno.2026.01.233","url":null,"abstract":"<div><h3>Background</h3><div>Mismatch repair deficient (MMRd) endometrial carcinomas (EC) encompass 25–30% of ECs. Identifying MMRd directs Lynch Syndrome testing and immune checkpoint inhibitor (ICI) therapy. Our aim was to characterize the clinicopathologic and molecular features of MMRd ECs treated in the pre-ICI era.</div></div><div><h3>Methods</h3><div>MMRd ECs were identified retrospectively and tumors underwent selective immunohistochemistry and hotspot panel sequencing.</div></div><div><h3>Results</h3><div>MMRd ECs (<em>n</em> = 899) were predominantly FIGO 2009 stage I (77%), endometrioid histotype (92%), with 14% lymph node metastases (LNM). Lymphovascular invasion and myoinvasion were prognostic in MMRd ECs, but grade and histotype were not. Patients with MLH1 loss (80%) were older with higher BMI, had more deeply invasive tumors and more LNM compared to patients with MSH2/MSH6/isolated PMS2 loss (20%). Worse outcomes were observed with MLH1 loss; 18% of patients recurred and 10% died of disease compared to 7% and 4% with MSH2/MSH6/isolated PMS2 loss. MLH1 loss tumors had lower CD8+ tumor infiltrating lymphocyte densities, which were associated with worse prognosis. ER, PR, L1CAM and <em>CTNNB1</em> were not associated with outcomes in MMRd ECs. There was no difference in outcomes between patients with MMRd-p53abn (<em>N</em> = 150, multiple classifiers) and MMRd ECs with wildtype p53 expression. Outcomes were identical for chemoradiation vs radiation alone for ESMO high risk or high/advanced/metastatic risk groups combined.</div></div><div><h3>Conclusion</h3><div>MLH1 loss identifies a subset of MMRd ECs with worse outcomes and lower CD8+ densities supporting substratification of this molecular subtype. Grade, histotype, ER, PR, L1CAM, <em>CTNNB1</em> and p53 status do not add prognostic refinement within MMRd EC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages 105-112"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}